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From the 9/3/2021 release of VAERS data:

This is VAERS ID 1368815



Case Details

VAERS ID: 1368815 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C214 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Incontinence, Pollakiuria
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 1 per day: aspirin 81 mg, trazadone 75mg, escitalopram 20 mg (am), escitalopram 10 mg (pm), oxybutynin 10 mg, metoprolol 100 mg, losartan 50 mg, hidroclorotiazida 12.5 mg 2 per day: omeprazole 20 mg,
Current Illness: none
Preexisting Conditions: over-active bladder, depression, high blood pressure, gastric by-pass,
Allergies: codeine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Sudden frequent urination and incontinence post 4 hours after 2nd dose. Continuing through next day post injection. Currently unresolved.


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